Transmanubrial approach for en bloc resection of oligometastatic extranodal extension positive lymph nodes with partial common carotid artery and trachea resection after esophagectomy.

BACKGROUND AND AIMS: The transmanubrial approach (TMA) provides excellent exposure of the cervical-thoracic border area, allowing for the resection of thoracic outlet structures while preserving the clavicle, avoiding muscle sacrifice, and maintaining full shoulder mobility.

METHODS

This report presents the first instance of TMA being utilized for oligometastatic, extranodal extension-positive lymph node dissection en bloc with partial resection of the common carotid artery and trachea following esophagectomy.

SURGICAL TECHNIQUE: We describe the surgical technique with illustrated explanations.